– PERFORMANCE MEASURE SETS –
Ambulatory Care Quality Alliance (AQA)
Cardiovascular Care Performance Measures

Performance Measure
Clinical Topic

Source of
Measure

PVRP
Measure

Description

Coronary Artery Disease

CAD – Level 1 (Core) Measures

CAD: Antiplatelet Therapy

CMS /
AMA /
ACC/AHA

–

Percentage of CAD patients who were prescribed antiplatelet therapy.
•	Numerator – Patients who were prescribed antiplatelet therapy
•	Denominator – All patients with CAD > 18 years of age

a.	Antiplatelet therapy may include aspirin, clopidogrel, or combination of aspirin and dipyridamole.
b.	Denominator Exclusion – Medical reasons for not prescribing antiplatelet therapy: active bleeding in the previous six months which required hospitalization and/ or transfusion(s), patient on other antiplatelet therapy, etc.
c.	Denominator Exclusion – Patient reasons for not prescribing antiplatelet therapy: economic, social, and/or religious, etc.

CAD: Beta-Blocker Therapy - Prior Myocardial Infarction (MI)

CMS /
AMA /
ACC/AHA

–

Percentage of CAD patients with prior MI who were prescribed beta-blocker therapy.
•	Numerator – Patients who were prescribed beta-blocker therapy
•	Denominator – All patients with CAD > 18 years of age with prior MI.

a.	Denominator Exclusion – Medical reasons for not prescribing beta-blocker therapy: Document.
b.	Denominator Exclusion – Patient reasons for not prescribing beta-blocker therapy: Document.

CAD – Level 2 Measures

CAD: Lipid Profile

CMS /
AMA /
ACC/AHA

–

Percentage of CAD patients who received at least one lipid profile (or ALL component tests)
•	Numerator – Patients who received at least one lipid profile (or ALL component tests)
•	Denominator – All patients with CAD > 18 years of age.

a.	Component tests include total cholesterol, HDL-C, LDL-C, and triglycerides.

CAD: ACE Inhibitor or Angiotensin Receptor (ARB) Therapy

CMS /
AMA /
ACC/AHA

–

Percentage of CAD patients with diabetes and/or LVSD who were prescribed ACE-I or ARB therapy.
•	Numerator – Patients who were prescribed ACE-I or ARB therapy
•	Denominator – All patients with CAD > 18 years of age age who also have diabetes and/or LVSD. Denominator Includes patients with CAD who also have diabetes and/or LVSD (LVEF <40% or with moderately or severely depressed LVSF)

a.	Denominator Exclusion – Medical reasons for not prescribing ACE-I/ARB: allergy, angioedema due to ACE-I/ARB, anuric renal failure due to ACE-I/ARB, pregnancy, moderate or severe aortic stenosis, etc.
b.	Denominator Exclusion – Patient reasons for not prescribing ACE-I/ARB: economic, social, and/ or religious, etc.

Heart Failure

Heart Failure – Level 1 (Core) Measures

HF: Left Ventricular Function (LVF) Assessment

CMS /
AMA /
ACC/AHA

–

Percentage of HF patients with quantitative or qualitative results of LVF assessment recorded.
•	Numerator – Patients with quantitative or qualitative results of LVF assessment recorded
•	Denominator – All patients with CAD > 18 years of age.

This measure requires only documentation of a previous LVF assessment anytime previous in the record and that reassessment should be based on a change in clinical status.

HF: Beta-Blocker Therapy

CMS /
AMA /
ACC/AHA

–

Percentage of HF patients with left ventricular systolic dysfunction (LVSD) who were prescribed beta-blocker therapy
•	Numerator – Patients who were prescribed beta-blocker therapy
•	Denominator – All patients with HF > 18 years of age with LVEF <40% or with moderately or severely depressed LVSF.

a.	Denominator Exclusion – Medical reasons for not prescribing beta-blocker therapy: Document.
b.	Denominator Exclusion – Patient reasons for not prescribing beta-blocker therapy: economic, social, and/ or religious, etc.

HF: ACE Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy

CMS /
AMA /
ACC/AHA

–

Percentage of HF patients with LVSD who were prescribed ACE-I or ARB therapy.
•	Numerator – Patients who were prescribed ACE-I or ARB therapy
•	Denominator – All patients with HF > 18 years of age with LVEF <40% or with moderately or severely depressed LVSF.

a.	Denominator Exclusion – Medical reasons for not prescribing ACE-I or ARB therapy: Document.
b.	Denominator Exclusion – Patient reasons for not prescribing ACE-I or ARB therapy: economic, social, and/ or religious, etc.

Heart Failure – Level 2 Measures

HF: Warfarin Therapy for Patients with Atrial Fibrillation (AF)

CMS /
AMA /
ACC/AHA

–

Percentage of HF patients with paroxysmal or chronic AF who were prescribed warfarin therapy.
•	Numerator – Patients who were prescribed warfarin therapy
•	Denominator – All patients with Heart Failure > 18 years of age with paroxysmal or chronic AF.

a.	Denominator Exclusion – Medical reasons for not prescribing warfarin therapy: Document.
b.	Denominator Exclusion – Patient reasons for not prescribing warfarin therapy: economic, social, and/ or religious, etc.

– PERFORMANCE MEASURE SETS –Ambulatory Care Quality Alliance (AQA)Cardiovascular Care Performance Measures